肾损伤112例诊治体会

目的: 提高肾损伤的诊断和治疗水平。方法: 回顾性分析112例肾损伤的临床资料,总结其诊断和治疗效果。结果: 血尿107例;B超检查112例,阳性率90.2%;CT检查38例均有异常;静脉尿路造影(IVU)检查8例,阳性率62.5%。非手术治疗88例,手术治疗24例。病死3例,治愈109例。38例随访4～36个月,尿常规、肾功能正常,B超检查有1例肾缩小,但IVU检查示肾功能正常。结论: B超和CT检查较可靠简便,无损伤,不受患者条件限制,还可进行病理分类,是诊断肾损伤的主要方法。准确评估伤情,严格掌握手术和非手术治疗的指征是处理肾损伤的关键。

Diagnosis and treatment of renal trauma:Report of 112 cases

Objective:To improve the diagnosis and treatment level of renal injury.Methods:The data of 112 patients with renal injury were retrospectively analyzed.Results:There were 107 patients with hematuria(95.5%)and 112 patients received B-ultrasonic examination.The positive rate was 90.2%.CT was used in 38 patients and all of them were abnormal.Intravenous urography(IVU)was used in 8 patients and the positive rate was 62.5%.Eighty-eight patients(78.9%)were treated conservatively while 24 patients underwent operation(21.1%).Three patients died of injury(2.7%)and 109 patients were cured.Thirty-eight patients(33.9%)were followed up for 4 to 36 months.The routine urine test and the renal function were normal.The kidney shrinking in only 1 patient was found by B-ultrasonography.With IVU examination every renal function was normal.Conclusions:The B-ultrosonography and CT are reliable,simple,noninvasive,and can be used in any patients.It can also be used for the pathological classification and the main means to diagnose the renal injury.To accurately assess the condition of injury is the key to master the indications strictly whether to take operation or conservative treatment of renal injury.